Analysis of Mutations in Dihydropteroate Synthase and Dihydropteroate Reductase Genes Among Non-HIV Patients in China.

PURPOSE

pneumonia (PJP) shows a high fatality rate in non-HIV patients. However, there are limited data on drug resistance-related gene mutations in these patients. This study aimed to describe the prevalence of mutations in the dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) genes of in non-HIV patients in China, providing a reference for drug usage.

METHODS

We analyzed the polymorphisms of DHPS and DHFR genes from 45 non-HIV patients in China, including infection (n = 14) and colonization (n = 31). This analysis also considered clinical characteristics, burden, treatment response, and prognosis.

RESULTS

Compared to the colonization, infection had significantly altered blood indicators (GR%, LY%, HGB, TP, ALB, CRP, <0.05) with higher burden (<0.05) and worse prognosis (<0.05). Additionally, patients with infection were more susceptible to infections, such as the Epstein-Barr virus, Cytomegalovirus, Mycoplasma and Klebsiella pneumoniae. Although no known drug-resistance mutations were detected in the DHPS gene in this study, 10 nonsynonymous mutations were identified. Furthermore, 10 nonsynonymous and 2 synonymous mutations were found in the DHFR gene. However, these mutations were not associated with a worse prognosis.

CONCLUSION

Our results implied that TMP-SMX prophylaxis is still recommended for PJP in high-risk non-HIV patients in China.